Yu Cheng-Sheng, Lin Chang-Hsien, Lin Yu-Jiun, Lin Shiyng-Yu, Wang Sen-Te, Wu Jenny L, Tsai Ming-Hui, Chang Shy-Shin
Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
J Clin Med. 2020 Feb 2;9(2):403. doi: 10.3390/jcm9020403.
Preventive medicine and primary health care are essential for patients with chronic kidney disease (CKD) because the symptoms of CKD may not appear until the renal function is severely compromised. Early identification of the risk factors of CKD is critical for preventing kidney damage and adverse outcomes. Early recognition of rapid progression to advanced CKD in certain high-risk populations is vital.
This is a retrospective cohort study, the population screened and the site where the study has been performed. Multivariate statistical analysis was used to assess the prediction of CKD as many potential risk factors are involved. The clustering heatmap and random forest provides an interactive visualization for the classification of patients with different CKD stages.
uric acid, blood urea nitrogen, waist circumference, serum glutamic oxaloacetic transaminase, and hemoglobin A1c (HbA1c) were significantly associated with CKD. CKD was highly associated with obesity, hyperglycemia, and liver function. Hypertension and HbA1c were in the same cluster with a similar pattern, whereas high-density lipoprotein cholesterol had an opposite pattern, which was also verified using heatmap. Early staged CKD patients who are grouped into the same cluster as advanced staged CKD patients could be at high risk for rapid decline of kidney function and should be closely monitored.
The clustering heatmap provided a new predictive model of health care management for patients at high risk of rapid CKD progression. This model could help physicians make an accurate diagnosis of this progressive and complex disease.
预防医学和初级卫生保健对慢性肾脏病(CKD)患者至关重要,因为CKD的症状可能直到肾功能严重受损时才会出现。早期识别CKD的危险因素对于预防肾脏损害和不良结局至关重要。在某些高危人群中早期识别快速进展至晚期CKD的情况至关重要。
这是一项回顾性队列研究,包括筛查的人群和开展研究的地点。由于涉及许多潜在危险因素,因此使用多变量统计分析来评估CKD的预测情况。聚类热图和随机森林为不同CKD阶段患者的分类提供了交互式可视化。
尿酸、血尿素氮、腰围、血清谷草转氨酶和糖化血红蛋白(HbA1c)与CKD显著相关。CKD与肥胖、高血糖和肝功能高度相关。高血压和HbA1c处于同一聚类且模式相似,而高密度脂蛋白胆固醇则呈现相反模式,这也通过热图得到了验证。与晚期CKD患者归为同一聚类的早期CKD患者可能面临肾功能快速下降的高风险,应密切监测。
聚类热图为CKD快速进展高危患者提供了一种新的医疗保健管理预测模型。该模型可帮助医生对这种进展性和复杂性疾病做出准确诊断。